Keep the NHS Public

The coalition’s Health and Social Care Bill faces it’s second reading today in Parliament today and threatens to drastically reorganise health care in this country. The average person interacting with their GP or hospital might not notice the changes immediately. But make no mistake, these proposals go to the very heart of our health service.

“A quick retrospective review of government policy since 1948 suggests there has not been a White Paper as reformist and radical as the current Government’s opening offering. For those who feared a meek and mild Government that would do nothing more than tinker and blinker with a discredited status quo, all fears have been allayed by this aspirational document.”

The Lancet in their latest editorial were even more blunt. Comapring the proposed changes to those of the fundholding experiment in the 1990s they said:

“The principle then was that GPs controlled the budgets to buy the specialist care their patients needed. Fundholding took years to implement, but evidence on short-term or long-term benefits for patients is lacking….there is sufficient uncertainty and concern about the changes outlined in the Health and Social Care Bill to pause, to learn from the past, and to consider what the changes mean for patients’ outcomes. As it stands, the UK Government’s new Bill spells the end of the NHS.” (emphasis added)

They described the Conservatives claim to be “the Party of the NHS” as “a commitment that seems particularly hollow now.”

The BMA, whilst welcoming some of the changes such as a greater focus on public health, are also highly sceptical of many of the proposed alterations to our health service:

“Enforcing competition and adding price into the competitive mix within the NHS will always be damaging – doing so at a time of huge pressure on public finances and while staff are dealing with major structural change could be disastrous. The NHS needs to find efficiency savings of £20 billion by 2014-15. This is already resulting in cuts to services and staff, which have a direct impact on patient care.”“The BMA is opposed to the idea that all NHS trusts should be forced to become foundation trusts by 1 April 2014, given the poor outcomes that have resulted in a small number of cases. Intensifying the pressure to achieve foundation trust status within the next three years could distort priorities and drive trusts to place the achievement of this target above all others, including safe patient care.”

The Health and Social care bill will radically alter the structure of the NHS and set us on course for a privately provided service. Management will be first to go, but the changes to Foundation Trusts and the desire to increase the number of social enterprises will mean that Hospitals and other services won’t be far behind. Check out this excellent video from Richard Blogger to see how:

What’s more, these changes will be forced through whilst overselling the need for reform at all. We’re told by the government that the biggest risk is to do nothing, that the NHS is inefficient and our health outcomes are worse than elsewhere. John Appleby, chief economist at the King’s Fund, writing in the BMJ last week, however, analysed mortality rates in the UK to discover that whilst our death rate from heart disease is indeed higher than that of France right now, on current trends we will be lower by next year. We’ll achieve that whilst spending just 8.7% of GDP on health compared with 11.2% in France. Other data paint a similar picture.